OBJECTIVE Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a novel pharmacotherapeutic option for pediatric type 2 diabetes (T2D); however, little is known about their current use. This study evaluated trends in GLP-1RA dispensing in youth with T2D between 2020 and 2023 and compared use by insurance type (ie, Medicaid vs commercial). METHODS We conducted a multiyear cross-sectional study of youth aged 10 to 17 years with T2D using Merative™ MarketScan® Multi-State Medicaid and Commercial Database claims and encounters data (2020-2023). Annual prevalence of GLP-1RA dispensing was calculated for each year. Temporal trends in dispensing were examined using the Cochran–Armitage test. Poisson regression with robust variance estimated adjusted prevalence ratios (aPRs) were used to evaluate associations between insurance type (ie, Medicaid vs commercial) and GLP-1RA dispensing in 2023. RESULTS Annual prevalence of GLP-1RA dispensing in youth with T2D increased from 10.9% in 2020 to 35.6% in 2023 (P value for trend .001) but remained less frequent than long- (49.5%) and short-acting insulin (43.4%). In 2023, overall GLP-1RA dispensing was similar for Medicaid-insured and commercially insured youth; however, the types of GLP-1RA differed by insurance. Medicaid-insured youth were less likely than commercially insured youth to be dispensed semaglutide (aPR 0.3, 95% CI: 0.2–0.4) and more likely to be dispensed dulaglutide (aPR 1.5, 95% CI: 1.2–2.0), exenatide (aPR 2.3, 95% CI: 1.2–4.2), or liraglutide (aPR 1.6, 95% CI: 1.2–2.1). CONCLUSIONS GLP-1RA dispensing increased in youth with T2D, but the type of GLP-1RA differed by insurance type. Comparative effectiveness studies and research identifying barriers to GLP-1RA use are needed to ensure optimal treatment of youth with T2D.
Chu et al. (Mon,) studied this question.
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